DROWNINGWhen a person is drowning, the air passages close to prevent water from entering the lungs. This also prevents air from entering the lungs, thus depriving the victim of oxygen and eventually leading to unconsciousness and death. Usually, only if the victim has been unconscious in the water for some time do the lungs fill up with water. More commonly, the water goes into the stomach.A secondary risk for the rescued person is that he or she may choke on vomit as water in the stomach forces the stomach contents upward. A near-drowning person also faces the risk of hypothermia. Children and young adults are at the greatest risk of drowning.

RESCUING A DROWNING PERSONAs in all first aid, the key rule is to protect yourself. A person who is drowning will strike out and pull down even the most competent swimmer; dirty water can hide dangers such as metal rubbish with sharp edges; and cold water can cause muscles to cramp very quickly. If possible, reach to the person from the safety using a pole, rope, or buoyancy aid to enable him to help himself out of the water. If in doubt about your ability to rescue the person safely, call for emergency help.

VOMITINGA person who has nearly drowned is very likely to vomit. Maintain a close watch for this. If the victim vomits while you are resuscitating him, turn him toward you, and clear out the mouth before turning him on to the back and resuming rescue breathing. If the victim vomits while in recovery position, clear out the mouth and keep a close eye on breathing to ensure that it has not stopped. If the victim is conscious and become sick encourage him to lean forward and give support while he is vomiting.

Do not make any effort to remove water from the lungs by applying chest compressions or abdominal thrusts. The risk of water in the lungs is minimal, while compressing the chest or stomach will increase the risk of the victim choking on his own vomit.

TREATMENT OF A NEAR-DROWNING VICTIMYour priority is to ensure an open airway and that the person is breathing.1. Open the airway by tilting the head, checking the mouth, and lifting the chin. Check for breathing for up to 10 seconds.2. If the victim is breathing, place into the recovery position.3. If the victim is not breathing, provide rescue breathing before moving on to an assessment of circulation and full CPR as necessary.

HYPOTHERMIAHypothermia is a lowering of the bodys core temperature and is very common secondary problem of near-drowning. If untreated, hypothermia leads to the breathing and heart rate slowing down and eventually stopping.

To reduce the risk of hypothermia in a case of near-drowning, place the victim on a blanket or layer of coats to insulate him from the ground. Remove wet clothing if you are able to replace it quickly with warm and dry clothing; if not, then cover the wet clothing with blanket and coats. Cover the head to prevent heat loss. Warm the external environment if possible.

Even in a conscious person, hypothermia can be a risk. Seek medical help as soon as possible.

SHOCKThe word shock can be used in a range ways, but when used in a first aid context it describes a physical condition that results from a loss of circulating body fluid. It should not be confused with emotional shock that might occur when a person has received bad news (although the external signs are very similar).

WHAT HAPPENS IN CASES OF SHOCKA severe loss of body fluid will lead to a drop in blood pressure. Eventually the bloods circulation will deteriorate and the remaining blood flow will be directed to the vital organs such as the brain. Blood will therefore be directed away from the outer area of the body, so the victim will appear pale and the skin will feel cold and clammy.As blood flow slows, so does the amount of oxygen reaching the brain. The victim may appear to be confused, weak, and dizzy, and may eventually deteriorate into unconsciousness. To try to compensate for this lack of oxygen, the heart and breathing rates both speed up, gradually becoming weaker, and may eventually cease.

Potential causes of shock include: sever internal or external bleeding; burns; severe vomiting and diarrhea, especially in children and the elderly; problems with the heart.

TREATMENT Warmth Air Rest Mental rest Treatment Help

SIGNS AND SYMPTOMS Pale, cold, and clammy skin Fast, weak pulse Fast, shallow breathing Dizziness and weakness Confusion Unconsciousness Breathing and heartbeat stopping

Shock kills, so it is vital that you can recognize these signs and symptoms. With internal bleeding in particular, shock can occur some time after an accident, so if a person with a history of injury starts to display these symptoms coupled with any of the symptoms of internal bleeding, advise her to seek urgent medical attention. Or take or send her to hospital.

WarmthKeep the victim warm but do not allow her to get overheated. If you are outside, try to get something underneath her if you can do easily. Wrap blankets and coats around her, paying particular attention to the head, through which much body heat is lost.

AirMaintain careful eye on the victims airway and be prepared to turn her into the recovery position if necessary, or even to resuscitate if breathing stops. Try to keep back bystanders and loosen tight clothing to allow maximum air to victim.

RestKeep the victim still and preferably sitting or lying down. If the victim is very giddy, lay her down with her legs raised to ensure that maximum blood and therefore maximum oxygen is sent to the brain.

Mental restReassure the victim but keep your comments realistic. Do not say that everything is going to be fine when it is obvious that here is something seriously wrong. Let the victim know that everything that can be done is being done and that help has been called for. If she has other concerns, try to resolve these.

TreatmentTreat the cause of the shock and aim to prevent further fluid loss.

HelpEnsure that appropriate medical help is on the way.BREATHING DIFFICULTIESIn a first aid situation you are likely to encounter a victim who has breathing difficulties. Psychological stress may trigger breathing problems that affect the bloods chemical composition, causing a range of symptoms that make the victim feel unwell. Accidents that include a heavy impact to the chest can cause injuries that result in sever breathing difficulties.

HYPERVENTILATIONThis is a breathing difficulty that may be triggered by the stress of an accident or some other form of emotional shock. the person over-breathes, causing level of carbon dioxide in the blood drop. This leads to a combination of the signs and symptoms listed below: Fast, shallow breathing Feeling of tingling in the limbs Dizziness Cramps Panic attacksTREATMENT1. If the victim is otherwise uninjured, remove her from the scene of the accident to a quiet place where there is no audience. People are hyperventilating often subconsciously react to onlookers, making themselves worse.2. Reassure the victim but remain calm and speak firmly. Encourage the victim to regain control of her breathing.3. If the situation persists, and you are certain that here is no underlying condition such as asthma or chest injury, let the victim inhale her own breathed-out air from a paper bag, which will help restore the balance of oxygen and carbon dioxide in the blood.4. Call a doctor or ambulance if symptoms do not disappear. Do not slap the victim---she may become violent and attack you, and you run the risk of being charged with assault.CHEST INJURIESSerious injuries following an accident, or the aftermath of any illnesses causing problems with breathing, can lead to the lung collapsing. Air enters the space between the lung and the chest wall, making breathing very difficult. In severe cases, the pressure affects the uninjured lung and the heart, causing a tension pneumothorax, a condition requiring urgent medical attention if the victim is to survive.

Chest injuries with more than one broken rib will often result in the victim having difficulty in breathing as the chest wall is unable to move effectively. There may also be an open break on the chest wall on the where ribs extend around the back and there may be injuries here as well as on the front.

Chest injuries may be accompanied by a sucking wound on the chest. Here there is a direct passage between the outside and the lungs, often caused by a puncture injury from a sharp object pushing through the chest wall.SIGNS AND SYMPTOMS OF COLLAPSED LUNG AND OTHER CHEST INJURIES History of chest impact or recent illness affecting breathing Chest rises as the person breathes out (paradoxical breathing) Swelling or indentation along the line of the ribs Open fractures Difficulty in breathing Pain on breathing Shock, as there is likely to be some degree of internal bleeding Bright red, frothy blood coming from the mouth and/or nose. (This is an indication of a punctured lung because oxygenated blood is escaping from the respiratory system. There may or may not be an associated sucking wound to the chest.) Sucking wound to the chestTREATMENTEnsure that an early call for emergency medical help has been made. If the victim is conscious, she will often find it easier to breathe if sitting up. Help her into a sitting-up position if possible and provide support to remain in this position comfortably. If you can determine the side of the injury, lean the victim to the injured side. This helps relieve pressure on the good lung, allowing the victim to breathe a little easier.

If there is an open sucking wound to the chest, cover this up as soon as possible.The best cover comes from using plastic sealed on three sides over the wound area. Help the victim remove blood from her mouth. If the person becomes unconscious, place into the recovery position on the injured side and monitor breathing carefully. Treat any open wound once the person is in the recovery position. Treat any broken ribs.RightReduced carbon dioxide levels in the blood can be restored to normal by slowly breathing into and out of the paper bag about 10 tASTHMAAsthma attacks cause the muscles of the air passages to go into spasm, making it very difficult for the asthmatic to breath, particularly to exhale. Attacks may be triggered by an allergy or by stress; for example, being involved in an accident. Sometimes the cause of the attacks for a particular suffer is never identified. There is evidence to suggest that asthma appears to be in increasing in frequency, or at least in diagnosis.

TREATMENTAn asthma attack should not be underestimated. While the preventive treatments are very effective, and the drugs to relieve attacks usually work very well, left untreated, a serious attack can be fatal. The strain of a serious asthma attack can cause the breathing to stop or the heart to cease beating. You should be prepared to resuscitate.

1. Reassure the victim as this will have a positive effect on his breathing.2. Help the victim into a sitting position, leaning slightly forward, as most of people with asthma find this an easier position for breathing.3. If the victim has a medication, enable him to use it. Inhalers are the main form of treatment.If this is the first attack, the medication does not work within 5 minutes, or the victim is in severe distress, then call an ambulance. Help the victim to take the medication every 5-10 minutes.If the attack eases and the person finds it easier to breathe, he will not need immediate medical attention but should advise a doctor of the attack. A person will often be very tired following an attack so it is best to ensure that he is accompanied home to rest.SIGNS AND SYMPTOMS History of condition (although some people may not realize that they are asthmatic and the first attack may be a sever one) Difficulty in breathing, particularly breathing out Wheezing or otherwise noisy breathing Inability to speak Pale skin and potential blueness. Particularly around the lips, caused by lack of oxygen Distress. Dizziness, and confusion as it becomes harder to get oxygen into the body Unconsciousness and then breathing stoppingUSING AN INHALERKnown asthmatics are usually prescribed an inhaler, a device that administers a measured dose of drugs inhaled directly into the lungs, where it will have a near-instant effect. Young children may find it hard to use ordinary aerosol inhaler and will need a spacer instead. Medication is put into the end of the spacer and the child breathes normally to take this in.Children under the age of four will usually require a face mask to use with the spacer as they cannot coordinate their breathing to inhale the drugs. If a member of your family is an asthmatic, make sure that everyone understands the importance of knowing where the inhaler is and that there is always enough medication in the house.

HEART PROBLEMSThe heart is a muscle that pumps blood around the body, which it does with the help of the thick-walled and muscular arteries and the other vessels of the circulatory system. The heart is controlled by regular electrical impulses that tell it when to contract. Like all other muscles, the heart needs its own blood supply and this is provided by the coronary (heart) arteries.When this blood supply fails to run smoothly, the body starts to experience problems such as angina pectoris (angina) and heart attack. Either of these may lead to the heart stopping (cardiac arrest).

ANGINAThroughout life, the arteries are clogging up with fatty deposits. As these fatty deposits cause the coronary and other arteries to become narrower, it becomes increasingly difficult for blood to flow around the body. The clogged coronary arteries can just about supply blood to the heart when it is pumping at a normal rate but when the heart rate speeds up the arteries cannot cope with the demand. This leads to an angina attack, a frightening, severe, crushing chest pain that acts as a warning to the victim to calm down or to rest.

TREATMENT1. Sit the victim down and reassure her. This reduces the demands being placed on the heart.2. Angina sufferers may have medicine that will help relieve an attack. This is often in the form of a puffer or a pill that is placed under the tongue. The drug works by dilating the blood vessels, thereby increasing circulation to the heart. Help the victim to take this medication.3. Call an ambulance if the pain does not appear to ease or if the victim is not known angina sufferer.4. If the victim has regular attacks, listen to what she wants to do next.HEART ATTACKIf a coronary artery becomes completely blocked, the area of the heart being supplied by that particular blood vessel will be starved of oxygen and will eventually die. This blockage may be caused by a clot, a condition often referred to as a coronary thrombosis.

The development of advanced cardiac care in hospital and good-post hospital care means that the heart attack patients have a good chance of making a full recovery. This is important information to remember when you are reassuring somebody having a heart attack.SIGNS AND SYMPTOMS OF A HEART ATTACKThese signs and symptoms are generally the same as those of angina--indeed, the patient may initially suffer an angina attack that becomes a heart attack. The key difference is that heart attacks do not always follow physical exertion. While angina sufferers will recover from their attack on resting, heart attack patients do not tend to improve without medical treatment.TREATMENT1. Move the victim into a semi-sitting position, head and shoulders supported and knees bent, as this is generally the best position to breathe in.2. Reassure the victim and do not let her move, as this will place an extra strain on the heart.3. Call for an ambulance as soon as possible because the victim needs hospital care.4. If the victim has angina medication, let her take this. If you have an ordinary aspirin, give her one to chew (without water).Keep a continual check on the breathing and pulse and be prepared to resuscitate if necessaryANAPHYLACTIC SHOCKAn allergy is hypersensitivity to a substance (allergen) that is normally considered to be harmful. Allergies are triggered by the immune system, which reacts to the allergen as though it were a harmful substance invading the body. The most extreme response is anaphylactic shock which, if untreated, can kill.

CAUSES OF ANAPHYLAXIS

This extreme allergic reaction has an intense effect on the body, causing a sudden drop in blood pressure and narrowing of the airways that can be fatal. Anaphylactic shock can be caused by anything but among the most common triggers are: nuts (for those who are particularly sensitive, even touching the trace of a nut can be potentially fatal), seafood, insect stings and bites, and drugs (some people have very extreme reaction to penicillin, for example).

As with asthma, the number of people suffering allergic reactions appears to be increasing. Whether this is because people are becoming more sensitive to allergens (the substances that cause allergic reactions) or whether we are just becoming better at detecting allergies, nobody is really sure.SIGNS AND SYMPTOMSOne of the main effects of severe anaphylaxis is a constrictions of the air passages in a similar way to asthma but generally more severe, preventing the intake of any oxygen at all. There may be a history of contact with a particular allergen, the thing that triggers the attack. Anaphylaxis can happen very quickly, within seconds.Signs and symptoms include: Difficulty breathing Pale skin and blue lips Blotches on the skin Rapid pulse Breathing and heartbeat stoppingTREATMENT1. Call an ambulance immediately. The victim needs epinephrine to counteract the reaction.2. If the victim is a known sufferer she may have an epinephrine injection. Help her to administer this. If you have been trained and the victim is unable to do so, you may give the injection.3. Place the victim in the most comfortable position reassure her.4. If the victim becomes unconscious, place in the recovery position. Monitor the victims breathing and circulation and be prepared to resuscitate if necessary.SKIN PRICK TEST FOR ALLERGIES

Skin prick tests are simple procedures carried out to find out what substances (allergens) cause allergic reactions in an affected person. Extracts of allergens that commonly cause allergic reactions, such as food, pollen, and dust are made into dilute solutions and are then placed on the skin. The skin is pierced to allow the substance to be absorbed.1. Dilute solutions of the substances that a person is thought to be allergic to are placed on the skin, usually the arm, and the skin is then pricked with a needle. Several different allergens can be tested on the skin at the same time.2. An allergic reaction usually takes place within 30 minutes of the test. If the person is allergic to the substance a red weal, indicating a positive reaction, appears at the site where the needle pricked the skin.HANDLING AN ATTACKMany anaphylaxis sufferers carry an auto-injector with a measured dose of a known treatment for an attack, most commonly epinephrine. This will often look like a pen. It is easily administered by placing against the skin and clicking the end. Help the person having the attack to find and inject the medication.

STROKE

A stroke occurs when a blood clot or bleeding cuts off the blood supply, and therefore the oxygen, to the part of the brain. The affected area of the brain will eventually die. The effect of a stroke depends on how much of the brain is affected and where the clot or bleeding is. Different parts of the brain control different functions, so a clot in the part of the brain that controls speech, for example, will result in slurred or confused speech. Often the signs will be confined to one side of the body.EFFECTS OF THE STROKE

If the bleeding or clot is in one of the larger blood vessels supplying a large area of the brain, then the stroke will often be immediately fatal. However, many people do survive, with some making a full recovery. Others may need extensive periods of rehabilitation and support to manage stroke-related problems such as reduced mobility.BelowIf a person has had a stroke and is still conscious, help her to lie down with her head and shoulders raised. Speak in a reassuring voice and seek medical help.LeftSimple tests can be performed at home to assess whether or not a person has suffered a minor stroke. A minor stroke may cause weakness on one side of the body or loss of sensation.TREATMENTMonitor airway and breathing and be prepared to resuscitate if necessary. Place the person in the recovery position if she becomes unconscious. If she is conscious, help her lie down with the head and shoulders slightly raised. Provide support and reassurance. The person will often be disoriented and may be speaking nonsense if the speech center is affected. Equally, she may hear what you are saying but not understand it. Speak in a reassuring tone with confidence. Call an ambulance. Wipe any dribbling away from the side of the face and prepared for the person to vomit.SIGNS AND SYMPTOMSAny combination of the following may be present. In minor stokes, the signs and symptoms may be very limited. History- the sufferer may have a history of smaller strokes over previous years, or may have been feeling unwell for some days with no known cause Headache Blurred vision, partial loss of sight, or seeing flashing lights Confusion and disorientation, often mistaken for drunkenness Signs of paralysis or weakness, often only down one side of the body (confirm by asking the patient to hold out both arms in front of her and look drooping or shaking) Difficulty speaking; drooping mouth or smile (caused by minor paralysis) Dribbling from one side of the mouth Loss of consciousness (this can be gradual or sudden) Sometimes the pulse will be full and throbbing, the persons breathing noisy, and the skin flushedEPILEPSYEpilepsy is very common condition, best described as a rogue electrical discharge across the brain. As the bodys functions are controlled by electrical impulses this discharged can lead to number of physical reactions. Many things may start seizure (fit): tiredness, stress, or flashing lights are common triggers.

MAJOR SEIZUREThis is what most people would recognize as epilepsy, and there are typically four stages:1. Many people get a sense that a seizure is likely to occur.2. The electrical impulses lead to a contraction in the muscles that causes the epilepsy sufferer to fall to the ground with a cry. This is known as the tonic phase. The victims muscles may then go into spasm. This is known as the clonic stage. During this stage the victim will not be breathing.3. When convulsion is over, the victim will be in state of unconsciousness.4. On recovery from unconsciousness, the victim will be very sleepy and will want to rest for some time.RightTry to protect a person during an epileptic seizure by moving sharp or heavy objects out of the way and placing a pillow or folded article of clothing under the head to cushion it.MINOR FITSDuring a minor fit, somebody with epilepsy suffers a brief disturbance in the brains normal activity, leading to a lack of awareness of his or her surroundings. To the observer it might seem like the person is daydreaming or has suddenly switched off.

There is little for you to do other than to guide the person away from danger and reassure him when he returns to normal. If he is not aware of any similar episodes happening before, advise him to see a doctor.TREATMENT FOR MAJOR EPILEPTIC SEIZURE1. During seizure, do not try to restrain the person. The muscular contraction are so strong during a fit that holding a person down may lead to broken bonesyours and his. Do not attempt to put anything in the mouth. Try to protect the victimmove sharp objects out of the way, remove constrictions and, if possible, place a soft coat under the head.2. Once the seizure has finished, check the victims airway and breathing and be prepared to resuscitate in the unlikely event that this is necessary. Place the person in the recovery position.3. When the victim comes round, offer reassurance. The person may have lost control of bowel or bladder function so cover him up and, when he is steady on his feet, help him to find somewhere to clean up. He is likely to be very tired so, if possible, find him somewhere to lie down and sleep. Most of all, ask him what he wants to domost epileptics manage the condition very well and will have their own coping strategies.AboveDuring minor fit a person may appear to have suddenly switched off. If this happens, stay by the person so that you can reassure him when his behavior returns to normal. Seek medical advice if this is the first episode.LeftAfter the seizure is over, check airway and breathing and place the victim in the recovery position.INFANTILE CONVULSIONS (CAUSED BY HEAT)Babies and young children may have seizures induced by a high temperature. This may be the result of an infection or because they are over wrapped and in a warm environment. The signs and symptoms are similar to a major epileptic seizure.TREATMENTMake sure that the child is protected from hitting himself on a bed or cotdo not attempt to restrain. Cool down by removing bedclothes and clothing where possible. Sponge the head and under the arms with a tepid flannel or sponge, re-soaking it regularly. When the convulsion is finished, check ABC and take action as appropriate. In most cases, the child will want to sleep. Dress him in dry clothes and let him sleep. Call a doctor for advice.

WHEN TO CALL AN AMBULANCEGenerally, neither epilepsy nor infantile convulsion are medical emergencies. However, you should be prepared to call an ambulance if: The victim is injured during the seizure. The seizure lasts for longer than 3 minutes. There are repeated seizures in a short period of time. The victim does not regain consciousness,If it is the first seizure, advise the victim to call his doctor or take him to hospitalUNCONSCIOUSNESS

Unconsciousness is an interruption of normal brain activity. It can happen suddenly or gradually. Unconsciousness can be caused by a range of injuries and medical conditions as well as by number of different drugs. An unconscious person may still have some reactions to pain or to commands, or may have no reactions at all.Whatever the cause or degree of unconsciousness, the immediate emergency treatment remains the same: Assess whether the person is unconscious by gently squeezing the shoulders and asking a question. Open airway by lifting the chin, clearing the mouth, and tilting the head. Check the breathing and be prepared to resuscitate if necessary. If breathing, check for life-threatening conditions and then turn into the recovery position. Call for emergency help.This may be all that you have time to do before emergency help arrives. However, if you have longer, there are some things that you can do to gather information that may help medical staff with their diagnosis and treatment.ASSESS THE LEVEL RESPONSEThere is an agreed scale for assessing how responsive an injured or ill person isthe Glasgow Coma Scale. A fully alert person will score 15 while somebody who is totally unresponsive will score 3 several variations. You can help collect information to inform medical staff using some of the checks from this scale:EYESDo they: Open without you having to ask the person to open them? Open in command? Open if you cause the person pain (this is often done by pinching the earlobe)? Remain closed?

MOVEMENTSDoes the person: Understand and follow sensible instructions? Move only in response to pain? Not move at all?SPEECHDoes the person: Answer questions sensibly? Answer questions in a confused way? Makes sounds that cannot be understood? Make no noise?Do the checks of eyes, movement, and speech every 10 minutes and record your answers.AboveThe easiest way to find the pulse is to press the hollow between the windpipe and large neck muscle with two fingers,AboveA pulse can be found at the wrist, although this can be more difficult to locate.MONITOR AND RECORD BREATHINGBreathing is measured by counting the number of breaths in1 minute (one breath being one rise and fall of the chest)MONITOR AND RECORD PULSE RATE

Pulse rate is measured by counting the number of beats at the pulse at either the neck or the wrist for 1 minute. The easiest place to feel a pulse is in carotid artery in the neck, though you can also check the wrist. Take recordings of breathing and pulse rate every 10 minutes and write down the results for the medical staff.FAINTINGA faint is a brief loss of consciousness. Shock is one of the potential causes of fainting but other causes include lack of food, reaction to emotional news, or long periods of inactivity, for example, guardsmen standing for a long time in the summer.

To treat someone who has fainted, open the airway and check for breathing. If the person is breathing and there are no signs of injury, then the best treatment is to lay her on her back with her legs raised.This puts maximum oxygen back to the brain and speeds up recovery from a faint. If she has not begun to come around after 3 minutes, or if breathing becomes difficult, put her into the recovery position for help.EXAMINING THE UNCONSCIOUS PERSONYour initial check of the injured or ill person will be for life-threatening conditions, particularly serious bleeding. If you have more time while waiting for the ambulance, a more thorough check may show up less serious injuries or illness and potential clues to the cause of unconsciousness. This check should never be at he cost of monitoring and maintaining the airway or of keeping the injured person as still as possible. If doing a check of the body, it is sensible to do so in the presence of a third person.Check the body from head to toe, looking for areas of bleeding, signs of broken bones or burns, or clues as to the cause of unconsciousness.DIABETESDiabetes mellitus is a medical condition in which the body is unable to effectively regulate the amount of sugar in the blood. The pancreas, an organ in the body) normally produces a hormone called insulin that regulates blood sugar level. In a person suffering from diabetes this does not happen effectively and as a result blood sugar levels become too high (this is known as hyperglycemia). Most diabetics control the condition through a combination of diet and injections of insulin. Too much insulin can lead to a condition known as hypoglycemia (low blood sugar).SIGNS AND SYMPTOMS

Early signs: Wanting to drink a lot (the body is trying to flush sugar from the system) Passing water regularly (urine may smell sweet) LethargyAs the condition deteriorates: Dry skin and rapid pulse Deep, labored breathing Increasing drowsiness Breath or skin smells strongly of acetone (like nail-polish remover) as the body tries to get rid of sugarHYPERGLYCEMIAHyperglycemia is most likely to occur in an undiagnosed diabetic. Diabetes is generally first noticed in early adolescence or in middle age. If left untreated, a high blood sugar level will lead to unconsciousness and death. Onset may be gradual with deterioration often happening over a number of days.TREATMENTDuring the early stages, encourage immediate contact with the local doctor. If this is difficult, or the condition deteriorates, take or send the person to hospital. Monitor airway and breathing and be prepared to resuscitate if necessary.HYPOGLYCEMIALow blood sugar level has a quick and serious effect on the brain. Most commonly it is caused by somebody with diabetes either taking too much insulin, or taking the right amount of insulin and then either not eating enough or burning off sugar through vigorous exercise. Less commonly, it can accompany heat exhaustion, alcohol abuse, or epileptic fits.TREATMENTIf the person is unconscious, monitor the airway and breathing and be prepared to resuscitate as necessary. If the person is fully conscious, help him to sit down or to lie down with the shoulders raised. Give something high in sugar and easy to consume, such as chocolate or a sugary drink, to try to restore the bodys chemical balance. If this marks an improvement, give more. If the condition does not improve, seek medical advice. Stay with the person until he recovers. Ask his guidance on what he wants to do next. Arrange for some help to take him home or to the doctor. If the condition continues to deteriorate, call an ambulance.SIGNS AND SYMPTOMS History of diabetes (however, a diabetic suffering a hypoglycemia attack is often confused or aggressive and may not admit to having a diabetes) Hunger Feeling faint or dizzy Strange behavior: confusion, aggression, or even violence Pale, cold, sweaty skin Rapid loss of unconsciousness Shallow breathing Evidence of diabetes, e.g. medic alert, sugar solution, or syringe in pocket Evidence of recent heavy exercise or drinkingCONFUSION WITH OTHER CONDITIONSIt is not unusual for diabetes to be mistaken for other common situations such as drunkenness, substance abuse, compression. The treatment in all these situations is to monitor and maintain the airway, be prepared to resuscitate if necessary, use the recovery position if the person becomes unconscious, and seek medical advice or call emergency help.Do not make assumptions as to the cause of the problem. Instead, look for clues to diagnosis for the medical staff. Somebody who is drunk may also be suffering from head injury; the syringe in a persons coat may be for diabetic medication or for drug abuse. While you do not need to know the cause the medical staff do and any clues that you can hand over could be potentially life-saving.

BLEEDINGBlood is carried around the body in a transport system of arteries, capillaries, and veins, and any damage to this network results in bleeding. Bleeding can be both external and internal. External bleeding involves a break to the skin surface, known as a wound, which can take may different forms. Internal bleeding is bleeding that occurs inside the body whe4n there is no external injury for the blood to escape from. The most common form of internal bleeding is a small bruise from a minor impact. Heavy impact from car accidents, fights, or falls, for example, can lead to serious internal bleeding, which may kill.TRANSPORT OF BLOODArteries have thick muscular walls, that contract. This pushes blood out from the heart under pressure. The blood contained within them is full of oxygen, which has been collected from the lungs, and the main function of the arteries is to take this oxygen-rich blood to the organs and body tissue. Because the blood is under pressure, and is full of oxygen, arterial bleeding is characterized by bright red blood pumping from an injury. Arterial bleeding is very serious as blood is rapidly lost.

Veins have thin walls and return blood from the organs and tissues to the heart. They do not have muscles of their own and rely on the actions of the muscles around them to squeeze the blood around the body, they have a series of one-way valves that ensure a one-way flow. When these valves deteriorate, blood pools in the veins, making them swell. This weakens the vein wall, resulting in a condition known as varicose veins. While the blood loss from bleeding vein does not tend to be as quick as bleeding artery, it does nonetheless have the potential to be very serious and even fatal injury and because it has little or no oxygen stored in the blood to be pushed out into the body tissues and organs.TYPE OF INJURYSmall blood loss is very common and rarely needs much treatment. Large blood loss may lead, if untreated, to shock and potentially, death.IncisionsClean and deep cuts characterized by paper cuts and knives are known as incisions. While these wounds do not tend to bleed a lot there may be underlying damage to tendons and other tissues,Lacerationsare jagged wounds, which tend to bleed a lot.

Punctured woundsare, as their names suggests, deep injuries caused by a pointes object such as a knitting needle. They do not tend to bleed a great deal but they carry the risk of infection because dirt can be carried a long way into the tissue. There is also a greater risk damage to vital organs such as the lungs or liver.

Scrapesare commonplace injury and involve damage to the top layers of the skin. They do not cause major blood loss but are often dirty, because grazes tend to have debris embedded with them.HOW DOES THE BODY STOP BLEEDING?When a blood vessel is torn or cut, a series of chemical reactions takes place that causes the formation of a blood clot to seal the injury. Components of the blood known as platelets clump together at the injury site. Damaged tissue and platelets release chemicals that activate proteins called clotting factors. These react with a special protein (fibrinogen) to form a mesh of filaments that traps blood cells. These form the basis of a blood cells to fight infection and specialized blood cells that help promote repair and recovery. A scab will form to protect the wound until repair has taken place. When applying pressure to the site of a wound you are helping the clotting process.

TREATMENT FOR EXTERNAL BLEEDINGComing across somebody who is bleeding heavily can be very frightening. It may be reassuring to remember that many adults donate up to a pint of blood with no ill effects, and yet if this the same amount were tipped onto the floor it would look very alarming. Serious shock in an adult tends to develop only after 2 pints of blood or more is lost from the body, and even this can be effectively treated with good first aid and early hospital care.

TREATMENTThe three main principles of the treatment of external bleeding are: Look Apply Elevate1. Look at the wound to check how large it is. Check that the wound has nothing in it (such as debris or a foreign body).2. Apply direct pressure to the wound. If the victim is able to press on the wound, encourage him or her to do so. If not, then apply direct pressure yourself, initially with your fingers and, if you have it handy, with a sterile dressing or a piece of clean cloth. Applying direct pressure to the wound enables the blood to clot and therefore stems the blood flow from the cut. Once applied, a sterile dressing (or whatever you have handy) should ideally be held in place with a firm bandage or improvised bandage such as a scarf or a tie.3. Elevate the wound. If the injury is an arm or leg, raise the wound above the level of the heart. It is harder for the blood to pump upward and this therefore reduces the blood flow and thus the fluid loss from the body.4. Treat for shock. Keep the victim warm and continually at rest. Reassure the victim.

PROTECTING YOURSELFWhenever possible, you should avoid direct contact with blood or other body fluids such as vomit. This is to protect both you and the person that you are treating. There are several ways of doing this: If available, use gloves. These come in many different sizes and materials (particularly useful if you have an allergy to latex) and should be kept in every first aid kit. If the person bleeding is able, ask her to apply direct pressure to the injury herself. Use bandages, dressings, or other materials, such as a handkerchief or T-shirt, as a barrier between your hand and the wound. Keep injuries in your own hands covered with plasters or dressings.If you do get blood on your skin, simply wash off well with soap and hot water. Clear up spills of blood or vomit with a bleach and water solution. Clothing that has been stained by blood or vomit should be put through a hot wash in the washing machine. If you are concerned about the possibility of infection after dealing with body fluids, contact your doctor. It is important to remember that the risk of cross-infection is minimal and that in most instances where you are applying first aid you will be doing so for member of your own family.

BLEEDING FROM THE HEAD OR PALMBleeding from the head is usually caused by a blow. The scalp in particular has a rich blood supply and even a small wound can bleed heavily. The palm of the hand is commonly cut while cutting objects or through a fall. Bleeding is often severe as the palm also has a rich blood supply. There are many tendons and nerves in the hand, and wounds to the palm may be accompanied by loss of movement or feeling in the fingers.

HOW TO TREAT HEAD BLEEDSTreatment should include taking full details of what happened and checking for signs of head injury, such as skull fracture, concussion, or compression.1. Help the injured person to sit down or lie down.2. Check for any signs of head injury. Treat as appropriate.3. Using sterile bandage apply direct pressure to the wound to stop the bleeding.4. Cover the wound with sterile dressing or clean pad. Tie this in place with a bandage.5. Take or send the victim to the hospital as soon as possible.If the victim becomes unconscious, monitor and maintain airway and breathing and be prepared to resuscitate as necessary.SIGNS AND SYMPTOMS OF SKULL FRACTURE, CONCUSSION, AND COMPRESSIONSkull Fracture Bruising to the eye socket Pain A bump or dent in the skull Straw-colored fluid coming from one or both ears Victim becomes increasingly drowsy and unresponsive over a period of time. Does she respond slowly to questions or commands? Is she having problems focusing?Concussion Pale skin Dizziness, blurred vision or nausea Headache Brief or partial loss of consciousnessCompression Person becomes increasingly drowsy and unresponsive Flushed and dry skin Slurred speech and confusion Partial or total loss of movement. Often down one side of the body One pupil appears to be larger than the other Noisy breathing, which become slow Slow, strong pulseHOW TO TREAT BLEEDING FROM PALM Help the victim to sit or lie down. Apply direct pressure to the wound and raise the arm. If the person has had a fall, take care to rule out a broken arm or collarbone before raising the arm. Place a sterile dressing or a clean pad in the hand and ask the victim to grip her fingers over it. Bandage the fingers so that they are clenched over the pad. Leave the thumb exposed. If there is an embedded object in the wound, treat the hand flat and bandage around the object. If tendon damage means that the fingers cannot be clenched, bandage the wound with the hand flat. Treat for shock if necessary. Keep the victim warm, at rest, and reassure him or her.Support the arm in an elevation sling and take or send the victim to hospitalTREATING CHEST OR ABDOMINAL WOUNDSThe chest wall protects the lungs, heart, and other essential organs such as the liver. A puncture wound to the chest can therefore be extremely serious. Wounds to the abdomen (stomach and intestines) are very serious. External bleeding may be severe and internal bleeding is likely, both of which will lead to serious shock. In addition, there may be damage to internal organs and the digestive system.CHEST WOUNDSCommon complications of penetrating chest wounds include: Collapsed lung (pneumothorax), caused by air entering the space between the chest wall and the lungs. This applies pressure to the lungs, causing them to collapse. The lung can also be damaged directly, causing it to fill with blood. Tension pneumothorax which occurs when the pressure builds up sufficiently to affect the uninjured lung and possibly even the heart. Damage to the vital organs such as the liverthis will result in severe shock as these organs have a large blood supply.TREATMENT1. Seal the wound using, in the first instance, your hand or the victims hand.2. Help the victim into a position that makes it easier for him to breathe. This will usually be sitting up and inclined to the injured side. This allows the uninjured lung maximum room to move and allows blood to pool on the injured side.3. Cover the wound with a dressing and cover the dressing with airtight material, such as plastic or foil. Seal this on three sides.4. Call an ambulance and treat for shock.If the victim is unconscious, monitor and maintain the airway, and be prepared to resuscitate if necessary (sealing the wound before resuscitating). Place the victim injured side down.SIGNS AND SYMPTOMS OF CHEST WOUNDS Difficulty with breathing Shock Bright red, frothy blood (blood with air in it) being coughed up or escaping from the wound. Pale skin with blue lips Sound of air being sucked into the chestTREATING ABDOMINAL WOUNDS1. Call an ambulance and help the victim to lie down in the most comfortable position.2. Consider the position of the wound. If it is verticalruns down the abdomenmoving the victim so that he is lying flat on the ground will help bring the edges together, ease discomfort, and help reduce bleeding. If the wound is horizontal, gently raising the legs will have the same effect.3. Place a large dressing over the wound and secure in place. Add pads to this dressing as necessary.4. Treat for shock.Support the wound if the victim coughs, vomits, or needs to be moved into the recovery position. Press lightly on the bandage to prevent intestines protruding, do not attempt to replace them. Cover with a clean piece of plastic film.MAJOR ORGANSDamage to any of the bodys major organs can be life-threatening and prompt action must therefore be taken to minimize the effects of injuries to the chest or abdomen. Even when external bleeding is slight, the risk of internal bleeding cannot be discounted. Knowing where in the body the organs are located will help first responder to assess a situation and decide the most appropriate emergency treatment, and also to give accurate information when the emergency services arrive.

CRUSHED INJURIESCrush injuries generally result from serious car accidents or explosions. There may be part of the body trapped under heavy debris; several broken bones, multiple external bleeding and much internal bleeding; burns form explosion; severe shock, deterioration into unconsciousness. If the person is impaled on an immovable object, treatment is similar to that for a foreign object embedded in wound. An amputation is where a part of the body has been severed. This may occur through a straight and heavy cut or through twisting and pulling under extreme force.TREATING CRUSH INJURIES1. Ensure that it is safe to approach the scene. If in doubt, call 911 and wait for help.2. Monitor and maintain airway and breathing and be prepared to resuscitate3. Treat major bleeding and cover smaller wounds with sterile dressings.4. Keep the injured person still dressings.5. Keep the injured person still and try to reassure him or her while waiting for help.6. Treat for shock.7. Make an early call for an ambulance and inform medical staff what has happened.IF THE INJURED PERSON IS TRAPPEDThere are additional risks for the injured person if any part of the body is trapped. Releasing the body may bring on severe shock as fluid leaks to the injured part.

An even greater cause of concerns is crush syndrome. Toxins build up around the injury site are trapped by an object crushing the person. If the object is removed, these toxins are suddenly released into the body, and kidneys, the organs chiefly responsible for flushing out toxins, are overwhelmed. This condition may be fatal.IF THE PERSON HAS BEEN TRAPPED FOR LESS THAN 10 MINUTESCrush syndrome takes some time to develop. If you can do so, safely remove the object. Treat as for crush injuries.IF THE PERSON HAS BEEN TRAPPED FOR LONGER THAN 10 MINUTESMake an early call for help, explaining the situation, but do not remove the object. Treat as for crush injuries and reassure the person.TREATING IMPALEMENT1. Do not attempt to remove the object or to move the injured person.2. Provide swift assistance for the injured person, supporting his body weight where possible to prevent any further damage.3. If bleeding is severe, apply pressure around the edges of the wound without pressing on the object.4. Try to stop the object moving around as much as possible, enlisting bystander support where available.5. Call an ambulance, making sure that you explain the need for cutting equipment tools.6. Treat for shock as best you can.TREATING AMPUTATION1. Your priority is to stop any bleeding at the site of the injury. Apply direct pressure and raise the injured stump. An amputation high on the arm or leg can be accompanied by severe arterial bleeding, particularly if caused by a twisting or tearing movement. Be prepared to apply continuous pressure using several pads as necessary. 2. If the bleeding comes under control, cover the wound with a sterile dressing or clean non-fluffy material tied in place with a bandage. 3. Treat for shock and reassure the person. 4. Call 911, advising that there is an amputation.FOR THE AMPUTED PARTA surgeon may be able to reattach amputated part.1. Wrap the part in a plastic and wrap the bag in a clean cloth.2. Place the cloth-wrapped bag in ice and place into a sturdy container. Do not let the ice come into close contact with the amputated part, because this will damage the flesh. Do not wash the amputated part.Label the container with the time of injury and the victims name and make sure that you personally hand it over to medical staff.